This retrospective study found that epithelial healing was delayed in smokers with corneal abrasions or keratitis compared to nonsmokers.

As ophthalmologists and corneal surgeons, we occasionally have to take a step back from the patient’s eye and remember that there is so much more that influences final outcomes. In ophthalmology, we are taught early on of the importance of smoking cessation for patients with macular degeneration, vascular ischemic disease and thyroid eye disease. Here, the authors find yet another negative association between tobacco smoking and ocular disease.

They reviewed the charts of patients diagnosed with corneal abrasions or keratitis who had undergone a systems review, including tobacco use.

Smokers had a significantly longer median time to corneal abrasion healing than nonsmokers (24.5 days vs. 9.5 days). In patients with keratitis, this delay in healing was even more pronounced. Even when adjusting for confounding factors, there was still a statistically significant delay in healing associated with smoking.

Additionally, patients who had undergone a previous keratoplasty had delayed healing from corneal abrasions regardless of smoking status, and keratitis patients with neurotrophic corneas and fungal infections experienced a delay in healing after correcting for smoking. Diabetes did not significantly delay epithelial healing after accounting for smoking.

Although there are always limitations inherent to a retrospective study, this interesting article highlights once again the importance of patient counseling. Patients should be aware of the effects that smoking may have on their eye health from cornea to cortex.